HeadWise Volume 3, Issue 3 | Page 31

you ask, our physician experts answer. kids’ korner “Sleep hygiene is a series of practices that allow for normal, good quality sleep. Many of the problems surrounding sleep are related to poor sleep hygiene.” sleep apnea. Headache can be one of the only signs of sleep apnea, particularly if headaches occur in the morning. Other possible symptoms of sleep-related breathing disorders include snoring, restless sleep, excessive daytime sleepiness, and difficulties with attention. Mood disorders like depression and anxiety also make falling and staying asleep much more difficult. In a child with migraine and insomnia, questions about feeling sad and/or anxious should always be asked. Sleep hygiene is a series of practices that allow for normal, good quality sleep. Many of the problems surrounding sleep are related to poor sleep hygiene. Other contributing factors include not allowing enough time for adequate sleep as guided by the age requirements stated above, excessive daytime napping, and caffeine consumption. In addition, technology and electronics are notorious sleep disruptors, making it very hard for us to fall asleep. So, how do we fix all of this? First, all children with migraine should be getting the recommended amount of sleep. Reasons that are delaying a child’s bedtime should be identified and addressed. If homework is the cause, the start time of homework should be moved earlier, or possibly some homework should be completed during free periods in the school day. If extracurricular activities are taking up the majority of the evening, some may need to be eliminated or done at a reduced frequency. Next, all children with migraine should practice good sleep hygiene. The importance of a steady routine cannot be understated. There should be a strict bedtime and awakening time that should remain the same on weekdays and weekends. The time leading up to bedtime should involve quiet activities, avoiding things that are stimulating including homework, exercise, and electronics. This is a good time to practice some meditation or relaxation exercises. The routine leading up to bedtime should be similar each night to create positive associations with going to sleep. Daytime caffeine should be reduced or eliminated and children should stay away from excessive fluids prior to bedtime. Napping during the day should be avoided, unless it is for brief and structured periods of time. The bedroom itself should be dark and quiet with a temperature that is in the low 70s. Children should learn to fall asleep alone without the presence of a parent. Electronics should be removed from the bedroom. There should be no television, computer, or tablet available at bedtime and phones should be charged in a different room overnight. With good sleep hygiene, 50% of sleep issues will resolve completely and an additional 40% will at least partially resolve. The longer one practices good sleep hygiene the more engrained and, thus easier, it becomes. With good sleep practices, migraine frequency will reduce, often significantly. All of those with migraine should make sleep high on the priority list, as sleep can be a migraine sufferer’s biggest ally. In addition, good sleep practices learned in childhood will carry through adulthood helping to keep migraine frequency low and improve overall health and well-being. HW Shannon Babineau, MD Icahn School of Medicine at Mount Sinai Medical Center New York, New York www.headaches.org | National Headache Foundation 31